“Polio alert! A must read everyone,” alerted a post on a women-only Facebook group shared in May.
The person sharing the post, however, did not author it. “Copied from another page but it [information] is useful for every mother. Share this information as much as possible!” she wrote.
The post, aimed at creating awareness on a “very important” issue, detailed a mother’s alleged ordeal of dealing with her child’s temporary paralysis triggered by an oral polio vaccine.
What followed was a list of suggestions for mothers. “When we consulted the doctor, we were told that the vaccine had expired. If your child is suffering from any viral infection, don’t get him vaccinated. When polio workers come to your house, they carry the vaccine in hands leaving the ingredients heated which should not be given to a child,” it warned.
The post received over 50 comments and 70 likes. While a few women pointed out the scientific flaws debunking the possibility of paralysis caused by polio vaccine, a majority of the women expressed alarm at the incidence. “This is so scary! Thank you for sharing. Must pass it on,” wrote one user.
A survey of polio-related content on Facebook revealed that the original post had, in fact, originated from India. The text had been reproduced in over seven groups (each with over 10,000 members). Neither of the users could trace it back to its creator.
Despite the lower penetration of women in online spaces of Pakistan, it is evident that parenting and women groups are influencing the anti-vaccine rhetoric.
A keyword search on polio in Urdu on Facebook and YouTube — two of the most used social media platforms in Pakistan? – props up scores of anti-vax posts and videos. The anti-vax content amplifies popular myths citing issues of infertility, portrays the polio drive as western propaganda, and claims that it poses threats to immunity and, even life.
While anti-vax misinformation may not necessarily have a gendered focus, the impact is certainly more lasting on women.
In a conservative society where healthcare is likely to be a maternal concern, it is women who take their kids to doctor appointments and face scrutiny for their children’s behaviour and abilities, which makes every decision — including whether to vaccinate — feel high-stakes.
Not surprisingly then, online communities are home to robust discussions on polio vaccination — often in a way that personal beliefs are presented as facts.
“Recently, there has been a spike in posts related to polio on the group as new mothers are worried whether to trust government (anti-polio) drops or not,” says Maryam Hashaam, who runs the Facebook group First Time Mommies Pakistan. “While majority may have positive things to say, 30 percent women believe that it’s best to not get their children inoculated at all to be on the ‘safe side’.”
Given the popularity of the topic, Maryam is organising a health awareness session with pregnant women to address their fears related to vaccination.
“People don’t investigate,” she says, adding, “they choose to remain doubtful.”
“When others also commented the same concerns, I felt my fear was valid and I refused the next time the polio team came.”
Amna – mother of a three-year-old girl
Reasons discussed for rejecting vaccines vary widely on groups such as First Time Mommies Pakistan, which has around 1,500 members. . A majority insists that the frequency of campaigns and administration of vaccine may weaken the child’s immune system.
“It is the age of Google parenthood,” says Amna, mother of a three-year-old girl. “More than the doctor, I go to Google for answers related to my child’s health. Now I see many mothers posting on Facebook about their problems. It is very helpful,”.
For Amna, and several other new parents, online “research” is the key to responsible parenting. “I was very worried about getting my daughter vaccinated twice in a week, so I posted on Facebook,” she says. “When others also commented the same concerns, I felt my fear was valid and I refused the next time the polio team came.”.
Others narrate how their lack of trust in polio workers stems from the workers’ intrusiveness and forceful behaviour.
“Why don’t they [polio workers] have documents to prove their identity?” Shumaila, an O’ Levels teacher, says. “How can I trust strangers like that with my children’s health? Only recently I read on a WhatsApp group that a house was robbed by people pretending to be polio workers.”
Shumaila says her family group on WhatsApp has 40 members. “Most of the messages on this group are forwarded as received. Only the other day my younger cousin (20 years of age) sent a very informative video on the reality of polio drops,” she says confidently.
On insistence, she shares the video titled “Polio vaccine cause of blood cancer” with me.
In the 11-minute-long clip, a young man questions the government and polio workers over the campaign’s legitimacy. Not only does he echo popular propagandist concerns that the vaccination is funded by the United States, he also includes footage purporting to be of an incident where polio workers are apparently forcing some parents to inoculate their children with assistance from police.
“Take the drops or the police will take you,”
a man warns a family in the clip.
The clip then goes on to show a foreigner validating claims about the vaccination being poisonous. The Urdu transcription is not in sync with the researcher’s claims and the text is highlighted in bold to create alarm.
Curated in a way that it retorts to facts presented by health organisations, the clip repeatedly discredits the Pakistan Drug Regulatory Authority and features officials, who are allegedly from the Pakistan Pharmacy Association and Director EPI and believe that the vaccination is dangerous.
“See? This (video) has solved the mystery for good. Now I show it to everyone who tries to convince me otherwise,” Shumaila maintains.
The officials of EPI have discredited the contents of the video and claim no association with it.
In April, thousands of children were rushed to a government-run hospital in Peshawar after unfounded rumours about children falling sick due to polio vaccination went viral. A video of a man, who claimed the children had been poisoned by the drops administered in a private school, had caused panic among the people.
Following the incident, the government sealed 10 private schools responsible for spreading hate and inciting innocent parents to violence resulting in attacks on polio teams and mass hysteria.
Amid serious security threats and increasing attacks on polio workers in different parts of the country, the federal government suspended the anti-polio campaign “for an indefinite period”.
For the first time in the history of Pakistan, the government also suspended the post-campaign evaluation — Lot Quality Assurance Sampling (LQAS).
A similar incident occurred in Mansehra in March 2019, when a campaign began on social media blaming the death of a child on the polio vaccine.
A team from the vaccination programme then visited the area and, upon investigating, found that the child had suffered from measles and recorded a statement from the child’s parents in which they said the death was not caused by the polio vaccine.
According to an official of the EPI programme, social media claims were followed by announcements from nearby mosques telling parents to take their children to hospitals because the polio vaccine was causing reactions. “Because of it, a crowd even burned a basic health unit,” the official added.
Bushra, a mother of two, says, “I received a notification from my child’s school located in Federal B Area of Karachi that the school was making inoculation of polio drops compulsory.” She adds, “At first, I appreciated the effort. But then I found out through a parents WhatsApp group that they would administer drops every two weeks and I got worried.”
The situation in the school escalated after a mother had raised alarm in the group that her child came home with blood stains on his uniform. “They told us about oral vaccine only. Why were they injecting vaccine without our consent? And why so frequently? I immediately posted on Facebook group and as it turned out, most mothers were not aware what schools were up to,” she says.
Many parents then protested against the decision of schools making polio vaccination compulsory.
“I have become paranoid. But, social media has really helped me stay informed. Teachers don’t keep us in the loop. So, I am thankful for these groups that I can keep myself updated with what’s happening around,” Bushra says.
“Parents have become more negative towards polio vaccine. Now they argue back with [false] information they found online. Some even try to ‘educate’ us by showing anti-polio videos they received on WhatsApp,” says a polio worker.
Recalling a recent spat with a mother, she said that people recorded videos of their visits on phone and spread on social media suggesting that polio teams were hostile towards parents.
“Parents have become more negative towards polio vaccine. Now they argue back with [false] information they found online.”— Polio worker
“I had a heated argument with a woman recently. She was hurling abuse and threatening to register FIR. The entire episode was recorded by a neighbour and uploaded online,” she says, adding that such misleading videos not only hindered the polio drive but was also damaging the repute of polio workers, who are mostly women.
Fahad Ahmed, Director of social media programme for polio says this is the first time in the history of the program that it is so invested in social media, “The programme penetration was low until now, but in the age of misinformation we are becoming increasingly involved with online communities,” he says The team? Now monitors online propaganda and prepares counter arguments using documentaries, graphics and short videos to spread the message. “The digital engagement of polio workers is necessary,” says Ahmed.
In recent months social media in the country has been inundated with fake news reports and videos — garnering thousands of views and shares — claiming numerous children have been killed by the polio vaccine. Thousands of parents have refused to allow their children to be inoculated.
As the polio campaign failed to deal with anti-vax disinformation, the government launched a crackdown against posts spreading “hatred and misinformation” about polio vaccination.
According to the Prime Minister’s Focal Person on Polio Eradication Babar bin Atta, hundreds of videos from YouTube and tweets have been removed. He added that Google has also issued a warning to those who were spreading anti-polio vaccine content on YouTube and that the process of issuing warnings is ongoing.
Atta says that the government had decided to speed up legal prosecution following a long video conference with Facebook officials.
“Until now the polio teams visited each house seven times for data collection and vaccination. Now, they have been ordered to visit each house twice only,”— Babar Bin Atta – PM’s Focal person on Polio Eradication
Facebook has been widely criticised for its anti-vax policies that allows content reach to be limited but not removed. However, based on the data provided by the government, the platform seems to have relaxed its limited reach policy.
“I am regularly in touch with the leadership of Facebook and the platform has been actively removing anti-vax content on our complaints. The [online] crackdown needs to be implemented on war-footing,” Atta says.
According to the updated figures provided by the government’s polio program, the government has so far blocked over 500 anti-vaccination posts. As per the breakdown, 270 posts had been suspended on Facebook, 135 on Twitter, 90 on YouTube and 10 on Dailymotion.
"In the age of misinformation we are becoming increasingly involved with online communities. The digital engagement of polio workers is necessary." - Faraz Ahmed, Director Social Media Programme for Polio
When contacted, Facebook said it was “fully committed” to the safety of its community in Pakistan and takes misinformation regarding vaccinations on the platform very seriously. “We regularly review reports for vaccine misinformation, whether those reports come from our community or the government, and we remove any content that violates our Community Standards,” a Facebook spokesperson told MMFD. The platform did not provide any statistics on the content they took action against.
Given the parent’s mistrust in the movement, the government, says Atta, is making more changes to the programme for community acceptance. “Until now the polio teams visited each house seven times for data collection and vaccination. Now, they have been ordered to visit each house twice only,” he says, while acknowledging concerns about frequent visits of workers.
He also shares that there would be no FIR registered against parents refusing to inoculate their children, adding that media groups have been taken on board to raise maximum awareness and counter vax hoaxes.
“This will be the largest ever polio campaign in Pakistan,” Atta says.
Author: Ramsha Jahangir
Ramsha Jahangir is an award-winning journalist who writes on technology & society, internet rights and digital politics. She tweets at @ramshajahangir